Survey confirms that obesity prevention fails at the first step.

Talking about being overweight with the doctor is taboo.

23 August 2018
- In many countries patients often do not see the doctor until after they've been weighed, but in the United Kingdom, a regular, standardised weighing rarely takes place in medical practices – although there is a protocol in the UK to weigh a patient at least once a year should they visit the practice. It's time for action. A representative survey contracted by seca, the leading manufacturer of medical measuring systems and scales, has shown that 42 percent of Britons are overweight and the average Body Mass Index (BMI) is 27.5. Weights are rising too. Within the past five years, 44 percent have gained weight, with 11 percent reporting gains of 15 kilograms or even more. Nevertheless, the subject of weight is still taboo in the doctor's office.

Patients are seldom weighed regularly at the doctor's office, so gradual changes often go unnoticed

68% of overweight persons say the doctor has never spoken to them about their weight.

Time constraints and a lack of financing are the biggest challenges in medical practices

seca calls for a policy to create opportunities for standardised weighing in a G.P. practice as an integrated obesity strategy

Prevention and early detection fail at the first step42 percent of Britons are overweight and almost one-fifth (19 percent) are obese (BMI 30 and higher). To some extent they face a very high health risk which continues to grow. 58 percent of overweight persons admit that they have gained weight in the past five years. More than one-third (35 percent) said they had gained 10 kilograms or more – a trend that must be stopped. However, the chance to recognise weight changes early and take appropriate measures is very often lost. 41 percent of those surveyed (38 percent of the overweight respondents) report that they had never been weighed by the doctor or could not remember having been weighed. In this case the doctor relies on the patient's reported weight. In the examination room when doctor and patient are face-to-face, it appears that overweight and obesity are still taboo topics. 68 percent of overweight subjects said that no doctor had spoken to them about their weight. At any rate, 7 percent had the courage to bring up the subject themselves and to ask for advice.

More time and financing for measuring would give doctors opportunities for early detectionA look at persons with normal weights clearly shows that regular weighing can be useful in early recognition of overweight and obesity. 32 percent of survey respondents with normal weight said they had gained weight over the past five years. This trend should draw attention. A doctor is unlikely to see the weight gain, however, as nearly half of these respondents (46 percent) said they had never been weighed or could not remember being weighed by the doctor. In this case too doctors rely on patient-supplied information.

Michael Johannes Maisch is a medical doctor and Chief Medical Advisor at seca. He understands the importance of early recognition of weight changes – and knows the challenges encountered every day in a medical practice. "In most cases changes in weight are insidious and often go unnoticed by the doctor for some time. Regular weighing at the doctor's office could make it much easier to detect changes early on. But in many practices, however, the process can be very time-consuming with around 50 patients seen per day. Many doctors only have about eight minutes per patient. Under these unfavorable pressure conditions, it is hardly possible for them to reproduce standardised weighing in their daily business – even if they want to and if it makes perfect sense.”

Political action needed: Recognition of obesity as a chronic disease would lead to more prevention and better careContrary to the widely accepted belief that obesity is a lifestyle phenomenon, it is in fact a chronic, progressive metabolic disorder with complex pathophysiology and the trigger of more than 60 concomitant illnesses such as Type 2 diabetes and cardiovascular disease. The disorders have serious consequences for patients and healthcare systems. The World Obesity Federation predicts that global costs associated with obesity will rise to 1.2 billion US dollars by 2015. An integrated obesity strategy is required to combat this problem. An effective strategy would include the implementation of a standardised weighing procedure at the doctor's office to ensure early detection of negative trends. Furthermore, seca is calling for holistic care of affected persons that takes into account personal needs and the stage of the disease and also includes regulated remuneration for measured aimed at prevention, treatment and follow-up care.

The WHO defined obesity as a chronic disorder in 2000 and medical associations share that view. Legislation should follow. Obesity must be seen and accepted as a disease. That would help to destigmatise the problem for those affected. Furthermore, it would pave the way for ensured care and improved access to preventive measures and conservative pharmacological and surgical treatment.

1 The data used is based on an online survey of YouGov Germany GmbH, in which 2257 people between 10.05.2018 and 14.05.2018 participated. The results were weighted and are representative of the English population over 18 years old.

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